1.Optimization of purification process and component analysis of alkaloids from Zanthoxylum bungeanum Maxim
Heying YANG ; Caiping LUO ; Ting PENG ; Wenyi LIANG ; Songzhang SHEN ; Juan SU
Journal of Pharmaceutical Practice and Service 2025;43(2):75-81
Objective To optimize the process conditions and analyze the components of alkaloids from Zanthoxylum bungeanum Maxim(Z. bungeanum)using macroporous resin. Methods Combining single factor tests and orthogonal tests, the content of hydroxy-α-sanshool(HAS)and hydroxy-β-sanshool(HBS)were considered as indexes to determine the best process parameters. Ultra-performance liquid chromatography-quadrupole tandem time-of-flight mass spectrometry(UPLC-Q-TOF-MSE)was used to identify the structures of alkaloids. Results The optimal conditions were Mitsubishi HP-20 macroporous resin, the loading solution concentration was 0.2 g crude drug/ml, the ratio of crude drug to resin volume was 1 g∶2.5 ml, the diameter/height ratio of resin column was 1∶7, the dynamic adsorption flow rate was 4 times of bed volume(BV)per hour, and the adsorption time was 1 h. Impurities were removed by using 2 BV of 20% ethanol, 5 BV of 80% ethanol was used to elution, and the content of HAS and HBS was 4.71% and 1.02%, respectively. A total of 20 alkaloids were identified from Z. bungeanum. Conclusion This method was stable and feasible, obtaining high purity and various kinds of alkaloids, which could be used for the enrichment and purification of alkaloids from Z. bungeanum.
2.The role of SIRT7 in regulating epithelial-mesenchymal transition(EMT)to promote glioma cell proliferation and migration
Jiang-Ting WANG ; Kai SUN ; Mou GAO ; Gang CHENG ; Wen-Ying LYU ; Chun-Hui ZHOU ; Lei LIANG ; Jian-Ning ZHANG
Medical Journal of Chinese People's Liberation Army 2025;50(1):57-68
Objective To investigate the expression of the histone deacetylase SIRT7 in glioma cells and its impact on epithelial-mesenchymal transformation(EMT),as well as its effects on proliferative,migratory and invasive capabilities of glioma cells.Methods Bioinformatics analysis was conducted on data from glioma patients in the Cancer Genome Atlas(TCGA)and the Chinese glioma Genome Atlas(CGGA)databases to explore the expression of SIRT7 gene in gliomas and its correlation with tumor grading,molecular characteristics and patient clinical prognosis.Glioma cells were randomly divided into control,SIRT7 knockdown,SIRT7 overexpression,drug treatment(10 μmol/L hydrochlorothiazide)and drug(10 μmol/L hydrochlorothiazide)+SIRT7 overexpression groups.The CCK-8 assay,cell scratch assay and Transwell assay were used to observe the effects of upregulating and downregulating SIRT7 expression on glioma cell proliferation,migration and invasion.RT-qPCR and Western blotting were employed to detect the effects of SIRT7 on the expression of neural cadherin(N-cadherin),Vimentin,E-cadherin,transforming growth factor-β(TGF-β),Ki-67,and Smad3 protein in glioma cells.Nude mouse tumor-bearing experiments were conducted to observe the effect of SIRT7 knockdown on glioma growth.Results Higher expression levels of SIRT7 gene were associated with poorer clinical prognosis(P<0.0001).SIRT7 expression levels were significantly correlated with tumor grading and 1p19q coding status(P<0.01).Compared with normal HA cells,glioma cells showed significantly increased SIRT7 expression levels(P<0.01).CCK-8 assay results indicated that,compared with control group,the proliferation activity of glioma cells in SIRT7 knockout group was significantly decreased(P<0.01),while SIRT7 overexpression group showed significantly increased proliferation activity(P<0.01).EdU assay results showed that,compared with control group,the proportion of glioma cells in the proliferative stage was significantly decreased in SIRT7 knockdown group(P<0.01),and significantly increased in SIRT7 overexpression group(P<0.01).Western blotting results revealed that,compared with control group,the protein expression levels of TGF-β,Smad3,N-cadherin and Vimentin were significantly decreased in SIRT7 knockdown group(P<0.01),while the expression level of E-cadherin protein was significantly increased(P<0.05).SIRT7 overexpression group showed significantly increased protein expression levels of TGF-β,Smad3,N-cadherin and Vimentin(P<0.05),and a significantly decrease in E-cadherin protein expression level(P<0.05).Scratch assay results indicated that,compared with control group,the migration ability of cells in SIRT7 knockdown group and drug group was significantly decreased(P<0.01),and SIRT7 overexpression group showed significantly increased cell migration ability(P<0.05).Compared with drug group,drug+SIRT7 overexpression group exhibited significantly increased cell migration ability(P<0.01).Transwell assay results showed that,compared with control group,the migration and invasion abilities of cells in SIRT7 knockdown group and drug group were significantly decreased(P<0.01),and SIRT7 overexpression group exhibited significantly increased migration and invasion abilities(P<0.01).Compared with drug group,drug+SIRT7 overexpression group showed significantly increased migration and invasion abilities(P<0.01).Nude mouse tumor-bearing assay results indicated that the volume and weight of glioma in SIRT7 knockdown group were significantly reduced compared with control group(P<0.01).Conclusions Glioma patients with high SIRT7 expression have poorer clinical prognosis.SIRT7 can regulate the TGF-β/Smad3 pathway to mediate EMT,promoting the proliferation and migration of glioma cells.SIRT7 knockdown can inhibit the growth of transplanted gliomas in nude mice.
3.Application value of preoperative hemoglobin/red cell distribution width ratio,prognostic nutritional index,and carcinoembryonic antigen in the diagnosis of colorectal cancer
Medical Journal of Chinese People's Liberation Army 2025;50(8):964-969
Objective To explore the application value of preoperative hemoglobin(Hb)/red cell distribution width(RDW)ratio(HRR),prognostic nutritional index(PNI)and carcinoembryonic antigen(CEA)in the diagnosis of colorectal cancer.Methods Data were retrospectively collected from 224 colorectal cancer patients admitted to Chaohu Hospital Affiliated to Anhui Medical University from September 2019 to December 2023,designated as colorectal cancer group,and 207 patients with benign colorectal diseases during the same period,designated as control group.General information,peripheral blood red cell,white cell,neutrophil,and lymphocyte counts,as well as CEA levels,were compared between the two groups.The HRR and PNI were calculated.Factors influencing the occurrence of colorectal cancer were analyzed.Multicollinearity analysis was performed on the selected variables,and variables with a variance inflation factor(VIF)<5 were included in the multivariate binary logistic regression analysis to identify independent influencing factors.A joint model was constructed using binary logistic regression analysis with HRR,PNI,and CEA.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of HRR,PNI and CEA alone and in combination.Calibration curves and decision curve analysis(DCA)were used to evaluate the calibration and clinical utility of the joint model.Spearman rank correlation analysis was performed to assess the correlation between nutritional status of colorectal cancer patients(evaluated based on PNI values)and various nutritional indicators[body mass index(BMI),hemoglobin(Hb),albumin(ALB),red cell count and lymphocyte count].Results Compared with control group,patients in colorectal cancer group had lower level of red blood counts,HRR,and PNI,and higher levels of RDW and CEA,with statistically significant differences(P<0.001).Binary logistic regression analysis showed that ALB,CEA,HRR and PNI were independent risk factors for colorectal carcinogenesis(P<0.05 or P<0.01).ROC curve analysis revealed that HRR had the largest area under the curve(AUC)for diagnosing colorectal cancer(0.721),while PNI had the highest sensitivity(64.2%).The combined diagnosis of colorectal cancer using HRR,PNI and CEA had an AUC of 0.784,with the sensitivity and specificity of 67.0%and 84.1%,respectively.Internal validation,calibration curves,and DCA indicated that the joint model had good discrimination,consistency,and clinical performance.Spearman rank correlation analysis showed significant correlations between Hb,ALB levels,red cell and lymphocyte counts,and PNI(P<0.05).The worse the nutritional status of colorectal cancer patients(the lower PNI values),the lower the values of nutritional indicators.Conclusions HRR and PNI have important diagnostic value for colorectal cancer and can improve diagnostic efficacy when combined with CEA.Moreover,PNI can effectively assess the nutritional status of colorectal cancer patients.
4.Comparative analysis of the efficacy of laparoscopic hiatal hernia repair combined with Toupet or Dor fundoplication for esophageal hiatal hernia
Sheng-Chang LIANG ; Jin-Lian WANG ; Yi-Bin GUO ; Qi ZHANG ; Yu-Peng ZHANG ; Ting-Bao CAO ; Kun-Peng QU
Medical Journal of Chinese People's Liberation Army 2025;50(9):1122-1128
Objective To investigate the postoperative efficacy of laparoscopic hiatal hernia repair(LHHR)combined with Toupet or Dor fundoplication for the treatment of esophageal hiatal hernia(HH).Methods A retrospective analysis was conducted on the case data of HH patients who underwent LHHR combined with Toupet(Toupet group,n=53)and Dor(Dor group,n=53)fundoplication between December 2018 and December 2022 in Department of General Surgery of Gansu Provincial Hospital.Intraoperative and postoperative recovery outcomes of both groups were observed.We analyzed and compared the incidence of dysphagia and gastroesophageal reflux disease questionnaire(GERD-Q)scores at preoperative and postoperative intervals of 1 month,6 months,and 1 year.The incidence of postoperative complications and the 1-year recurrence rate were compared between the two groups.Additionally,factors influencing postoperative dysphagia within the first month were examined.Results The differences between the two groups in operation time,intraoperative bleeding,postoperative ventilation time,postoperative extubation time and hospitalization time were not statistically significant(P>0.05).There was no significant difference in the incidence of immediate postoperative dysphagia in two groups(P>0.05).Furthermore,the differences between the two groups in the incidence of postoperative complications,such as bloating,abdominal pain and diarrhea,were not statistically significant(P>0.05).The incidence of dysphagia in Toupet group was higher than that in Dor group at 1 month postoperatively,and the difference was statistically significant(P=0.017);but the difference in the incidence of dysphagia between the two groups at 6 months and 1 year postoperatively was not statistically significant(P=0.767,1.000).The results of binary logistic regression analysis showed that both surgical procedure(OR=2.613,95%CI 1.141-5.983,P=0.023)and esophageal contractile reserve function(OR=2.921,95%CI 1.203-7.095,P=0.018)were independent risk factors for the incidence of dysphagia in patients with HH at 1 month after surgery.Compared with the preoperative period,the GERD-Q symptom scores were lower in both groups at 1 month,6 months,and 1 year postoperatively,and the difference was statistically significant(P<0.05);but there was no statistically significant difference between the groups at the same time point(Fintergroup=0.334,P=0.565).The difference between the two groups in 1-year postoperative recurrence rates was not statistically significant(P>0.05).Conclusions LHHR combined with Toupet or Dor fundoplication are both safe and effective surgical procedures for the treatment of HH,with excellent reflux control,fewer complications and lower recurrence rates,but Toupet fundoplication is more likely to have postoperative short-term dysphagia than Dor fundoplication.
5.Effects of electroacupuncture on the expression of metabolic enzymes and autophagy genes in gastrocnemius muscle tissues of exercising rats
Rongfa ZHENG ; Weibin MO ; Peng HUANG ; Junji CHEN ; Ting LIANG ; Fangyu ZI ; Guofeng LI
Chinese Journal of Tissue Engineering Research 2025;29(6):1127-1136
BACKGROUND:Acute exercise tends to cause skeletal muscle tissue damage and lipid metabolism disorders in vivo,but the mechanism by which acute exercise combined with electroacupuncture modulates metabolic and autophagic pathways in vivo is unclear. OBJECTIVE:To observe the changes in metabolic enzymes and autophagy levels in skeletal muscle of rats subjected to acute exercise by electroacupuncture at the acupoints of"Zusanli"and"Huantiao." METHODS:Fifty male Sprague-Dawley rats were randomly divided into three groups:quiet control group(n=10),model group(n=20),and reverse electroacupuncture group(n=20).The latter two groups were set up with two time points,i.e.immediate and 3 hours after exercise groups(n=10 per time point).The model group and the reverse electroacupuncture group underwent acute exercise training after adaptive treadmill training.The rats in the reverse electroacupuncture group underwent electroacupuncture treatment(parameters:electroacupuncture on both sides of the rats at the acupoints of"Zusanli"and"Huantiao,"continuous wave,frequency of 2 Hz,intensity of 2 mA,leaving the needle in the body for 30 minutes,once a day for 7 consecutive days)before treadmill training.Bilateral gastrocnemius muscle tissues were taken under anesthesia immediately after exercise and 3 hours after exercise,and hematoxylin-eosin staining was used to observe the histopathological changes of rat skeletal muscle.ELISA kit was used to detect the activities of hepatic lipase,fatty acid synthase,hormone-sensitive lipase,and carnitine palmitoyltransferase 1 in rat skeletal muscle tissues.Immunohistochemistry and western blot were used to detect the changes in the expression of autophagy genes. RESULTS AND CONCLUSION:After hematoxylin-eosin staining,the arrangement of gastrocnemius muscle fibers in the model group was disturbed,swollen and ruptured immediately after exercise and 3 hours after exercise.In the reverse electroacupuncture group,gastrocnemius muscle fibers were tightly arranged and the number of swollen and ruptured cells was greatly reduced immediately after exercise and 3 hours after exercise,and there was no significant difference when compared with the quiet control group.Compared with the quiet control group,the activities of hepatic lipase and fatty acid synthase were lower while the activities of lipoprotein lipase,hormone-sensitive lipase,and carnitine palmitoyltransferase 1 were higher in the model group and the reverse electroacupuncture group 3 hours after exercise(P<0.05 or P<0.01).Compared with the model group,the activities of lipoprotein lipase and carnitine palmitoyltransferase 1 were higher in the reverse electroacupuncture group immediately after exercise(P<0.05),while the activity of lipoprotein lipase was higher and the activity of hormone-sensitive lipase was lower in the reverse electroacupuncture group 3 hours after exercise(P<0.01).Immunohistochemical results showed that compared with the quiet control group,the expression of P62,autophagy-related gene 5 and autophagy-related gene 7 was higher in the model group immediately and 3 hours after exercise,as well as in the reverse electroacupuncture group immediately after exercise(P<0.05 or P<0.01);compared with the model group,the expression of P62 and autophagy-related gene 7 was lower in the reverse electroacupuncture group immediately and 3 hours after exercise(P<0.05).Western blot results showed that the protein expression of P62 and autophagy-related gene 7 in the reverse electroacupuncture group was lower than that in the model group immediately after exercise(P<0.05);the protein expression of Parkin in the model group was higher than that in the quiet control group immediately and 3 hours after exercise(P<0.05);and the protein expression of Parkin in the reverse electroacupuncture group was lower than that in the model group immediately and 3 hours after exercise(P<0.05).To conclude,acute exercise induces disorders,swelling and rupture of gastrocnemius muscle fibers in rats and electroacupuncture on both sides of the acupoints of"Zusanli"and"Huantiao"can improve the level of lipid metabolism and regulate autophagy cells in rat skeletal muscle,preventing the disorders of lipid metabolism and damage of gastrocnemius muscle tissues caused by acute exercise.The mechanism may be closely related to the regulation of autophagy-related factor P62,autophagy-related gene 5,autophagy-related gene 7,and Parkin protein expression to promote the occurrence of autophagy or regulate the autophagy pathway in rat skeletal muscle cells.
6.Exploration on the effects of transcutaneous electrical acupoint stimulation combined with resistance training on stroke related sarcopenia based on propensity score matching method
Xiaoyu LIANG ; Ting ZHU ; Haiping JIANG
International Journal of Traditional Chinese Medicine 2025;47(11):1521-1526
Objective:To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) combined with resistance training on stroke related muscle atrophy(SRS) based on propensity score matching (PSM) method.Methods:A retrospective analysis was conducted on the clinical data of 150 cases of SRS patients in our hospital from September 2022 to September 2024. The patients were divided into an observation group of 78 cases and a control group of 72 cases according to the treatment method. Using PSM method to balance the confounding factors before treatment in a 1:1 ratio, 40 cases were successfully matched in each group. The control group received resistance training, while the observation group received TEAS treatment in addition to the control group. Both groups received continuous treatment for 12 weeks. Before and after treatment, the MedTrack Length isokinetic muscle strength testing system was used to measure the patients' knee extension and flexion axis muscle strength values, and the body composition analyzer was used to measure the patients' muscle weight and muscle index. The Berg Balance Scale (BBS), Fugl Meyer Motor Function Scale (FMA), and Simplified Upper Limb Function Scale (STEF) were used to evaluate limb motor function. ELISA method was used to detect the levels of muscle growth inhibitor (MSTN), growth differentiation factor 15 (GDF-15), and insulin-like growth factor-1 (IGF-1). The occurrence of adverse reactions during the treatment of two groups and the clinical efficacy was evaluated.Results:The total effective rate of the observation group was 92.50% (37/40), while that of the control group was 75.00% (30/40), with statistical significance ( χ2=4.50, P=0.034). After treatment, the observation group showed higher levels of knee extension [(78.25 ± 6.11) Nm vs. (74.02 ±6.02) Nm, t=3.11], flexion axis muscle strength [(32.84 ± 4.11) Nm vs. (29.35 ± 3.94) Nm, t=3.88], muscle weight [(41.42 ± 3.06) kg vs. (38.29 ± 3.12) kg, t=4.53], and muscle index [(7.11±1.17) kg/m 2vs. (6.56 ± 1.05) kg/m 2, t=2.21] compared to the control group ( P<0.01 or P<0.05). After treatment, the BBS, FMA and STEF scores in the observation group were higher than those in the control group ( t=4.57, 3.23,2.73, respectively, P<0.01), and the levels of serum MSTN [(46.34 ± 5.98) μg/L vs. (51.44 ± 6.04) μg/L, t=3.79] and GDF-15 [(67.44±7.21) μg/L vs. (72.28 ± 8.04) μg/L, t=2.83] in the observation group were lower than those in the control group after treatment ( P<0.01); the level of IGF-1 [(37.92 ±5.66) ng/L vs. (31.09 ± 4.22) ng/L, t=6.11] was higher than that of the control group ( P<0.01). During the treatment period, the incidence of adverse reactions in the observation group was 10.00% (4/40), while in the control group it was 7.50% (3/40), without statistical significance ( χ2=0.16, P=0.692). Conclusion:TEAS combined with resistance training can improve muscle strength and weight in SRS patients, improve limb motor function, reduce serum markers related to muscle attenuation, and have good treatment safety.
7.Study on the Characteristics of Traditional Chinese Medicine Syndrome and Syndrome Elements of Hypothyroidism Induced by Immunotherapy in Patients with Advanced Non-Small Cell Lung Cancer
Wenjing ZHANG ; Zhanpeng LIANG ; Ao ZHANG ; Ting CHEN ; Huatang ZHANG ; Cantu FANG ; Luzhen LI
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(2):283-292
Objective To explore the characteristics of traditional Chinese medicine(TCM)syndrome,syndrome elements and their combination,and the distribution of TCM syndrome types in advanced non-small cell lung cancer(NSCLC)patients suffering from hypothyroidism after treatment with immune checkpoint inhibitors(ICIs).Methods The analysis was conducted on 168 patients with NSCLC at stage ⅢB-ⅣB confirmed by pathological findings,whose epidermal growth factor receptor/anaplastic lymphoma kinase(EGFR/ALK)was negative,and then suffering from hypothyroidism after treatment with ICIs from January 2020 to June 2023,who admitted to Zhongshan Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine.The patients'information collected by four diagnostic methods of TCM was analyzed,and then cluster analysis was used to explore the characteristics of TCM syndrome and the distribution of TCM syndrome types of immunotherapy-induced hypothyroidism in advanced NSCLC.Moreover,the distribution of TCM syndrome types in the patients with different genders,age groups,and hypothyroidism grades was analyzed.Results(1)The TCM syndrome of hypothyroidism appearing in 168 patients with advanced NSCLC after immunotherapy was characterized by deficiency type,which manifested as follows:cough,fatigue and weakness,amnesia,lusterless complexion,spontaneous sweating,dry skin,white sputum,unwilling to talk,dizziness,nocturnal polyuria,blurred vision,emaciation,poor skin elasticity,poor appetite or even anorexia,somnolence,long-term poor appetite,edema,insomnia,low voice,dull pain,light white color of fingernails,spitting,frequently intolerance of cold,thirst,bright pale complexion,preference of warmth and aversion to cold,thirst with preference of hot drink,dyspnea,frequent constipation,dry stools,puffiness of face and eyelid,dreaminess,abdominal fullness,lumbar pain,and weakness in defecation.The tongue manifestation and pulse condition were characterized by white and thin coating,pale-red tongue,tongue with tooth-marks,pale and enlarged tongue,pale tongue,deep pulse,slippery pulse,feeble pulse,weak cubital pulse,and thready pulse.(2)The disease-location syndrome elements usually involved in the lung,spleen,and kidney,and the disease-nature syndrome elements usually involved in qi deficiency,yang deficiency,blood deficiency,and water retention.(3)The cluster analysis yielded three syndrome types,and they were lung and spleen qi deficiency syndrome,kidney yang deficiency syndrome,and qi deficiency and water retention syndrome in decreasing sequence of occurrence frequency.(4)Statistically significant difference of the distribution of TCM syndrome types was presented in the patients with various age groups(P<0.01).Lung and spleen qi deficiency syndrome was the main syndrome type in the patients aged 60-69 years old,kidney yang deficiency syndrome was frequently seen in the patients being or over 70 years old,and qi deficiency and water retention syndrome was frequently seen in the patients less than 50 years old.No statistically significant difference of the distribution of TCM syndrome types was presented in the patients with various genders and in the patients with various grades of hypothyroidism(P>0.05).Conclusion The immunotherapy-induced hypothyroidism in patients with advanced NSCLC is usually differentiated as the TCM syndrome types of lung-qi and spleen-qi deficiency,kidney yang deficiency,and qi deficiency and water retention.Deficiency of healthy qi contributes to the fundamental pathogenesis of the development and progression of the disease.Clinicians should pay attention to the changes of symptoms in time and monitor the thyroid function indicators of the patients,thus to avoid serious immunotherapy-related adverse events(irAEs).
8.Characteristics of Traditional Chinese Medicine Syndromes in Patients with Concurrent Postmenopausal Osteoporosis and Knee Osteoarthritis
Xin CUI ; Huaiwei GAO ; Long LIANG ; Ming CHEN ; Shangquan WANG ; Ting CHENG ; Yili ZHANG ; Xu WEI ; Yanming XIE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):257-265
ObjectiveTo explore the characteristics of traditional Chinese medicine (TCM) syndromes in the patients with concurrent knee osteoarthritis (KOA) and postmenopausal osteoporosis (PMOP) and provide a scientific basis for precise TCM syndrome differentiation, diagnosis, and treatment of such concurrent diseases. MethodsA prospective, multicenter, cross-sectional clinical survey was conducted to analyze the characteristics of TCM syndromes in the patients with concurrent PMOP and KOA. Excel 2021 was used to statistically analyze the general characteristics of the included patients. Continuous variables were reported as
9.Characteristics of Traditional Chinese Medicine Syndromes in Patients with Concurrent Postmenopausal Osteoporosis and Knee Osteoarthritis
Xin CUI ; Huaiwei GAO ; Long LIANG ; Ming CHEN ; Shangquan WANG ; Ting CHENG ; Yili ZHANG ; Xu WEI ; Yanming XIE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):257-265
ObjectiveTo explore the characteristics of traditional Chinese medicine (TCM) syndromes in the patients with concurrent knee osteoarthritis (KOA) and postmenopausal osteoporosis (PMOP) and provide a scientific basis for precise TCM syndrome differentiation, diagnosis, and treatment of such concurrent diseases. MethodsA prospective, multicenter, cross-sectional clinical survey was conducted to analyze the characteristics of TCM syndromes in the patients with concurrent PMOP and KOA. Excel 2021 was used to statistically analyze the general characteristics of the included patients. Continuous variables were reported as
10.Study on Kinetic and Static Tasks With Different Resistance Coefficients in Post-stroke Rehabilitation Training Based on Functional Near-infrared Spectroscopy
Ling-Di FU ; Jia-Xuan DOU ; Ting-Ting YING ; Li-Yong YIN ; Min TANG ; Zhen-Hu LIANG
Progress in Biochemistry and Biophysics 2025;52(7):1890-1903
ObjectiveFunctional near-infrared spectroscopy (fNIRS), a novel non-invasive technique for monitoring cerebral activity, can be integrated with upper limb rehabilitation robots to facilitate the real-time assessment of neurological rehabilitation outcomes. The rehabilitation robot is designed with 3 training modes: passive, active, and resistance. Among these, the resistance mode has been demonstrated to yield superior rehabilitative outcomes for patients with a certain level of muscle strength. The control modes in the resistance mode can be categorized into dynamic and static control. However, the effects of different control modes in the resistance mode on the motor function of patients with upper limb hemiplegia in stroke remain unclear. Furthermore, the effects of force, an important parameter of different control modes, on the activation of brain regions have rarely been reported. This study investigates the effects of dynamic and static resistance modes under varying resistance levels on cerebral functional alterations during motor rehabilitation in post-stroke patients. MethodsA cohort of 20 stroke patients with upper limb dysfunction was enrolled in the study, completing preparatory adaptive training followed by 3 intensity-level tasks across 2 motor paradigms. The bilateral prefrontal cortices (PFC), bilateral primary motor cortices (M1), bilateral primary somatosensory cortices (S1), and bilateral premotor and supplementary motor cortices (PM) were examined in both the resting and motor training states. The lateralization index (LI), phase locking value (PLV), network metrics were employed to examine cortical activation patterns and topological properties of brain connectivity. ResultsThe data indicated that both dynamic and static modes resulted in significantly greater activation of the contralateral M1 area and the ipsilateral PM area when compared to the resting state. The static patterns demonstrated a more pronounced activation in the contralateral M1 in comparison to the dynamic patterns. The results of brain network analysis revealed significant differences between the dynamic and resting states in the contralateral PFC area and contralateral M1 area (F=4.709, P=0.038), as well as in the contralateral PM area and ipsilateral M1 area (F=4.218, P=0.049). Moreover, the findings indicated a positive correlation between the activation of the M1 region and the increase in force in the dynamic mode, which was reversed in the static mode. ConclusionBoth dynamic and static resistance training modes have been demonstrated to activate the corresponding brain functional regions. Dynamic resistance modes elicit greater oxygen changes and connectivity to the region of interest (ROI) than static resistance modes. Furthermore, the effects of increasing force differ between the two modes. In patients who have suffered a stroke, dynamic modes may have a more pronounced effect on the activation of exercise-related functional brain regions.

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